World Vision Magazine, Spring 2007

[(c) September 2006/Jon Warren/World Vision]

Indian women bear the brunt of a burgeoning AIDS crisis.

By Dean Owen

Sudha’s home is sparse—even by the standards of India’s dense, dirty, and disease-ridden slums. There’s no two-burner propane stove; no television. The only reminder of electricity is a bare light bulb hanging from the ceiling, its wires protruding from a cracked, unpainted concrete wall.

Just a teenager, sudha bears the responsibilities of an adult, working full-time and keeping house for her two brothers. She's also haunted by memories of her dying mother's last days. [(c) September 2006/Jon Warren/World Vision]

In the adjacent room, three blackened bricks surround a small hole in the floor. Nearby, there are a bundle of dry twigs and a few tin pots. This is where Sudha will cook dinner tonight. The home is reminiscent of those in countless villages in sub-Saharan Africa. But here in Bellary, a city of 350,000 about 200 miles northwest of Chennai, there is a more compelling comparison to life in Africa. Sudha and her two brothers are living on their own—orphaned by AIDS. The disease has established a deadly foothold in this nation of more than 1.1 billion. According to the United Nations, upward of 9.4 million Indian children and adults are infected with HIV, eclipsing South Africa as having the most people in the world carrying the virus. Without a comprehensive prevention program, that number is expected to exceed 20 million cases by 2010 and kill 11 million within the next two decades.

"This family's situation was really quite pathetic when we first met them," says World Vision's Samson Tangod. Living conditions are still basic—Sudha uses discarded rope as fuel. [(c) September 2006/Jon Warren/World Vision]

Those statistics do not worry Sudha. What does worry her is getting to work on time at a nearby cotton mill, where she earns the equivalent of 90 cents after an eight-hour day, and making sure her younger brother, 11-year-old Guru, who is HIV-positive, keeps up with his studies. And of course, there’s always cleaning the home, laundering their clothes, and preparing meals. Quite a challenge for a 13-year-old girl.

Fortunately, the family came to the attention of World Vision. The organization has been helping Sudha, Guru, and 17-year-old Hulaganna for about a year and a half, providing nutrition supplements and regular checkups with a local physician. Last spring, World Vision added running water and a bathroom to the children’s home.

How did Sudha end up running their household? Her deep chestnut-colored eyes moisten with tears as she relates her story.

“My mother, she worked hard and earned money for our family,” she says. “She took care of us so well. But I cannot forget the last month of her life. That picture will not leave my mind.”

The food and health assistance that World Vision provides is essential for Guru, Sudha's younger brother, who is HIV-positive. [(c) September 2006/Jon Warren/World Vision]

Five years ago, Sudha bore the burden of caring for her dying mother, who was a devadasi—a temple prostitute (see related story). As a result, all three of the children have different fathers and they don’t know the men’s identities. “What my mother did was not right,” Sudha says. Her voice trails off into awkward silence.

Then she regains her composure, adding, “But my mother loved us and we loved her.”

Such stories of orphaned children are all too familiar to Heather Ferreira, World Vision’s HIV and AIDS program officer in Mumbai. Her staff of 12 conduct prevention, care, HIV-testing, and advocacy programs, and she also oversees a volunteer 10-member troupe of street theater performers, who sing, dance, and perform sketches to press home to Mumbai residents the importance of HIV-prevention.

It’s not just the devadasi system that makes women especially vulnerable to AIDS. Their low social and economic status puts them in a weak position to insist on safe sex in any context, according to Dr. Nafis Sadik, U.N. Secretary-General’s Special Envoy for AIDS in Asia and the Pacific.

Women must be empowered to reduce their vulnerability to AIDS, Nafis contends, “through greater commitment by leaders at all levels to protect women from violence, improve their access to education, prevention, treatment, and reproductive health services, and increase support for women caregivers.”

In Mumbai, World Vision runs an AIDS education workshop for teen girls. [(c) September 2006/Jon Warren/World Vision]

It is common in India that when a husband dies of AIDS, the wife is frequently ostracized by her parents and in-laws for supposedly infecting her spouse. In reality, says Heather, the overwhelming majority of HIV-positive women are married and monogamous. They contract the virus from their husbands, who often were infected by other partners, including prostitutes.

“If I can make [an HIV-positive] woman stronger, if I can get her medication, if I can help her keep her children in school, then there’s hope,” says Heather, who has worked for World Vision for 16 years.

She adds that discrimination, while once prevalent throughout the nation, has diminished—at least in urban communities. She recalls taking an HIV-positive woman to six Mumbai hospitals in 1998, all of which refused to admit her. “I fear that what I experienced years back is still happening in rural and remote places,” she says.

Whether urban or rural, many women and families affected by AIDS resign themselves to poor treatment. “The common words are, ‘It is our destiny.’ ‘God wanted it this way.’ ‘Maybe I deserve it,’ or, ‘It is our lot as we are poor,’” says Heather.

But one who refuses such admonishments is World Vision volunteer Jyotsna Kamble, 44, an AIDS counselor in Mumbai.

Joytsna knows intimately the pain experienced by those she helps.

World Vision trains volunteers, such as Jyotsna, to care for AIDS-affected families. [(c) September 2006/Jon Warren/World Vision]

She contracted HIV from her husband, who died of AIDS in 1995. And—true to the pattern Heather outlined—she was devastated when her in-laws and neighbors shunned her. “After my husband’s death, my in-laws wanted me to leave the house along with my two children,” she says. “But I fought back. Today I am able to live in my husband’s house, but initially it was a big problem.”

Partly because of these experiences and partly because of her Christian faith, Jyotsna was inspired to dedicate her life to helping others facing similar persecution. She admits to some hesitation at first, fearing further rejection, but her prayers strengthened her resolve. For the last six years she has delivered food and other necessities to AIDS-shattered families, but just as importantly, she dispenses comfort and encouragement.

Among her “clients” is 12-year-old Dinesh Sonawane—orphaned by AIDS and HIV-positive himself. She visits him regularly in an eight-story building known as a “vertical slum.”

The boy sits against the one bed in the apartment he shares with his paternal grandmother Satyabhana. His small physique and thin black hair resemble those of a 5-year-old.

The child’s frail voice becomes a bit stronger when he’s asked about school and his hopes for the future.

“I want to work in an office, a big office,” Dinesh says proudly. He opens a Winnie-the-Pooh backpack to show visitors several textbooks and completed written assignments, most with good grades and few corrections highlighted in red pen. His school’s third grade curriculum includes English, penmanship and, his favorite subject, math.

Joytsna offers a warm embrace and heartfelt smile to Dinesh and his grandmother as she leaves their small apartment. “I help them to cope with the disease,” Joytsna explains. “Whatever the problem may be, we have to face it and live life to the best.”

Living life to the best, for India’s women and girls, ultimately means having a role in developing policies that affect them—especially now in the era of AIDS. The United Nations’ Global Coalition on Women and AIDS promotes initiatives providing women with leadership training and advocacy skills, equipping them to make their voices heard. Meanwhile, women aren’t shying away from the hard work of combating a killer disease close-up. Any doubts? Just ask Heather, Jyotsna, and young Sudha.

—Dean Owen is a media relations director for World Vision.
—Jon Warren is the photo director for World Vision and photo editor for World Vision magazine.

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The feature above was published in World Vision Magazine—Spring 2007[pdf]. Other features from this issue include: Afghanistan: Battle-Scarred Courage — Women and girls hold the key to a war-torn country’s survival. Gender Matters — Three stories of girls’ suffering.

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